微量元素与神经管畸形关系的病例对照研究

张卫; 任爱国; 裴丽君; 郝玲; 欧阳荔; 钟新艳; 章斐然; 刁慈辉; 骆维波; 周林籽; 张美琳; 李竹

文章摘要

张卫,任爱国,裴丽君,郝玲,欧阳荔,钟新艳,章斐然,刁慈辉,骆维波,周林籽,张美琳,李竹.微量元素与神经管畸形关系的病例对照研究[J].中华流行病学杂志,2005,26(10):772-776

微量元素与神经管畸形关系的病例对照研究

A case control study on the relationship between trace elements and human neural tube defects

收稿日期:2005-11-18 出版日期:2014-09-15

DOI：

中文关键词: 神经管畸形微量元素病例对照研究

英文关键词: Neural tube defects Trace elements Case control study

基金项目:中美出生缺陷病因合作研究项目

作者	单位	E-mail
张卫	100083 北京大学生育健康研究所
任爱国	100083 北京大学生育健康研究所
裴丽君	100083 北京大学生育健康研究所
郝玲	100083 北京大学生育健康研究所
欧阳荔	北京大学公共卫生学院
钟新艳	山西省太原市妇幼保健院
章斐然	江苏省无锡市妇幼保健院
刁慈辉	浙江省慈溪市妇幼保健院
骆维波	浙江省奉化市妇幼保健院
周林籽	山西省平定县妇幼保健院
张美琳	浙江省宁海市妇幼保健院
李竹	100083 北京大学生育健康研究所	lzh@public bta.net cn

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中文摘要:

目的探讨多种微量元素与神经管畸形的关系，及其他危险因素。方法采用1：1配比的病例对照研究方法，在“中美出生缺陷监测系统”中，募集新近发生的88对神经管畸形病例和对照，问卷调查出生缺陷其他已知危险因素的暴露情况;采用微波消化、原子吸收、ICP质谱分析等方法，测定了病例和对照孕妇怀孕早期阶段，毛发中必需微量元素(铬、锰、铜、锌、钴、钼)、毒性元素(铅、砷、镉、汞)以及部分稀土元素(钇、镧、镨、钕)的含量;用Cox比例风险模型进行了流行病学多因素分析。结果孕期发热是神经管畸形的危险因素(OR=6．525，P=0．034)，而孕妇早期发锌含量(OR= 0．541 μg/100 g，P=0．02)和产前检查次数(OR=0．634，P＜0．001)作为保护性因素保留在多因素模型中。结论孕早期锌缺乏可能是神经管畸形的原因之一，避免孕早期发热性感染，以及定期产前检查，可降低神经管畸形的发生率。

英文摘要:

Objective To explore the relationship between multi-trace elements levels in hair and human neural tube defects as well as other risk factors. Methods Using 88 paired cases and controls, an 1:1 matched case control study was carried out. The study subjects were collected from the China-U.S. Collaborative Project on Neural Tube Defects Prevention and Birth Defects Surveillance System. Risk factors were obtained by field investigation with standardized questonnaires and hair trace elements levels were determined by AAS and ICP-MS methods. Microwave digestion was used to digest hair samples. The detected elements would include three groups, namely nutritional elements:Cr,Mn,Cu,Zn,Co,Mo; toxic elements: Pb,As,Cd,Hg; and Lanthannons: Y,La,Pr,Nd. Cox Proportional Hazard Regression Model was used to perform risk factors analysis. Results Pregnancy fever appeared to be a risk factor of neural tube defects (OR=6.525,P=0.034) while hair zinc level(OR=0.541 μg/100g,P=0.02) and times of prenatal physical examination(OR=0.634,P<0.001) served as two protective factors appeared in the last model. Conclusion Zinc deficiency might serve as a risk factor for human neural tube defects, suggesting that the avoidance of pregnancy infectoin together with more periodical prenatal physical examination might reduce the incidence of neural tube defects.

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